A poll by the Institute of Governmental Studies at the University of California-Berkeley shows more than half of Californians fear they or a family member will lose health coverage if the Affordable Care Act is repealed.
For those with household incomes of less than $20,000 per year and people enrolled in Medi-Cal, the concern is even greater. Medi-Cal covers 13.5 million Californians, and nearly 4 million of those enrolled were covered as a result of Medi-Cal’s expansion under Obamacare.
“We all have friends or relatives who are or have been on this program,” said Jennifer Kent, director of the State Department of Health Care Services, which administers Medi-Cal. “The state has literally bent over backwards to make the ACA work. This poll is basically now showing that people are appreciating what has been built and are worried that it’s going to be taken back down again.”
The GOP bill passed by the House in early May would eliminate the major tenets of Obamacare and cap federal funding of Medicaid. The Congressional Budget Office estimated that the bill would cause nearly 23 million more people to lose health coverage by 2026 and federal spending on Medicaid would be cut by $834 billion over 10 years.
U.S. Senate leaders are drafting their own version of a health bill with a vote expected before July 4.
The changes to the ACA addressed in the American Health Care Act will not be final until passed by Congress but already criticism of some of the key aspects are being voiced by some Republican Senators. All are from states that expanded Medicaid under the ACA and indicated they would not support a plan that would leave millions of Americans uninsured. In a letter to Senate Majority Leader Mitch McConnell, Senators Rob Portman of Ohio, Shelley Moore Capito of West Virginia, Cory Gardner of Colorado and Lisa Murkowski of Alaska stated “We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states.”
Medicaid expansion implemented in the ACA would end in 2020 under the new Act. People already enrolled would continue to get coverage, but new enrollees would be prohibited, and those who leave coverage could not return to expanded coverage.
Other key changes include:
- Suspension of the mandate requiring individuals to sign up for health insurance – However, there would be a 30% surcharge if you let your coverage lapse and want to get coverage at a later date.
- Elimination of the premium subsidies for those with low to middle incomes – These would be replaced with tax credits for individuals who have annual incomes below $75,000 or married couples with annual incomes below $150,000.
- Pre-existing conditions will continue to be covered and charged at the same rate as those without pre-existing conditions. The ban on lifetime and annual limits would remain in place.
- Some large employers would not have to offer health coverage to employees – However, the 40% Cadillac Tax would remain in effect on plans that cost more that $10,200 for individuals and $27,500 for families.
- Under the new plan insurers could charge older people five times what they charge younger ones. Under the ACA, it was capped at three times the rate.
- Children up to age 26 can remain on their parents’ plans under the American Health Care Act – Same as the ACA
Qualifying Event Necessary for Sign-Up
| With many insurance companies losing money on Federal Exchange plans, the Obama Administration is tightening rules on allowing people to sign up outside of the Open Enrollment Periods.
Insurers claim the rules are too broad with people getting coverage because of an illness rather than a legitimate Qualifying Life Event. That leads to higher healthcare costs because an influx of “sicker” people increases cost of coverage. Now there are 33 categories that allow people to sign up during Special Enrollment Periods throughout the year. The Qualifying Life Events include circumstances like getting married, divorced, losing a job, moving, having a child, or gaining citizenship. Federal officials said nearly 950,000 people enrolled outside of Open Enrollment between February and June of 2015.
For a complete list of qualifying life events, go to Life Events.
For most people, the premium for Part B Medicare will be $121.80 in 2016. Part B recipients paying for Part B through Social Security in 2015 will still be paying $104.90 in the new year. Those new to Medicare and those delaying Social Security will pay the higher amount.
Cost Sharing Amounts for 2016 are as follows:
|Part A Deductible||$1,288 deductible for each benefit period|
|Hospital||Days 1-60: $0 coinsurance for each benefit period|
|Days 61-90: $322 coinsurance per day of each benefit period|
|Days 91 and beyond: $644 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)|
|Part B Deductible||$166.00 annual deductible|
|20% of Part B charges|